Connect with a USO Pathfinder Scout
To request supportive services from the United
Service Organizations, Inc. (“USO”) related to Employment, Family Support,
Education, Housing, Finance, Health & Wellness, Legal, and/or Veterans
Benefits (collectively, “Supportive Services”), complete the relevant portions
of this Application for Supportive Services. Before USO can provide Supportive Services,
you must also review and agree to the terms and conditions of the Certification
and Authorization for Release of Information below. If you need help or have questions while
completing this process, please email email@example.com.
Authorization for Release of Information
By clicking “Submit”:
(1) I certify that the information that I have
provided in this Application for Supportive Services is true, accurate, and
complete, to the best of my knowledge. I understand that
misrepresentation, falsification, or omission of information could disqualify
me from receiving Supportive Services, and that I may be asked to provide
documentation verifying the statements that I have made.
(2) I authorize USO to receive, maintain, and release
the foregoing information — and any additional information that I choose to
provide to USO— to other organizations and individuals who are involved in
assisting in the delivery of the requested Supportive Services. I
understand and accept the risk that any disclosure of information carries with
it the potential for unauthorized re-disclosure. This Authorization for Release of Information
shall remain in effect unless I revoke such authorization in writing, which I
may do at any time, except to the extent that such information has
already been disclosed.
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